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For Many, Affordable Care Act Won’t Cover Bariatric Surgery

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For Many, Affordable Care Act Won't Cover Bariatric Surgery - via NPR

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Mr. MM newly post op

JACKSON, Miss. — Uninsured Americans who are hoping the new health insurance law will give them access to weight loss treatments are likely to be disappointed.

That's especially the case in the Deep South, where obesity rates are among the highest in the nation, and states will not require health plans sold on the new online insurance marketplaces to cover medical weight loss treatments like prescription drugs and bariatric surgery.

Dr. Erin Cummins directs the bariatric surgery department at Central Mississippi Medical Center in the state capital of Jackson. She grew up in the Delta, her husband is a cotton farmer, and although she's petite and fit, she understands well enough how Mississippians end up on her operating table.

"You have to realize in the South, everything revolves around food. Reunions, funerals, parties — everything revolves around food," Cummins says.

That long-standing food culture, as well as other factors like inactivity and poverty, have saddled Mississippi with the highest obesity rate in the nation.

Credit: Produced by Dave Anderson/Oxford American; Narrated by Debbie Elliott/NPR

Roughly 1 in 3 adult Americans is now obese. And ground zero for the nation's obesity battle is Mississippi — where 7 of 10 adults in the state are either overweight or obese. The problem is most pronounced in Holmes County — the poorest and heaviest in the state.

Doctors here are no longer surprised to see 20-somethings with diabetes, hypertension, sleep apnea, heart disease and severe joint pain. And the prevalence of severe and super-obesity is growing rapidly. For those patients, bariatric surgery is considered the most effective treatment to induce significant weight loss.

Cummins describes the procedure: "We're restricting the stomach size to where a patient isn't going to eat as much. Then we reroute the intestines a little bit and realign it to delay digestion, so to speak, to bypass it. So everything a patient eats in a gastric bypass is not going to be absorbed."

After surgery, many of the complications of obesity, like sleep apnea and high blood pressure, are reversed. Multiple studies have found that about 80 percent of diabetics can stop medication in the first year.

Medicare and about two-thirds of large employers cover bariatric surgery in the U.S. But the procedure is pricey — an average of $42,000 — and many small employers, including those in Mississippi, don't cover it.

When the Affordable Care Act became law in 2010, one goal was to erase those sorts of regional variations in access.

"Our hope was that there would be a single benefit for the entire country, and as part of that benefit there would be coverage for obesity treatment," says Dr. John Morton. He is director of bariatric surgery at Stanford University Morton, and has led national and state lobbying efforts to get insurance coverage for teh surgery.

But amid worries that a uniform set of benefits would be too expensive in some states, and sensitive to the optics of the federal government laying down one rule for all states, the U.S. Department of Health and Human Services changed course. It decided instead to match benefits to the most popular small group plan sold in each state, in essence reflecting local competitive forces.

That's led to an odd twist: In more than two dozen states, obesity treatments – including intensive weight loss counseling, drugs and surgery – won't be covered in plans sold on the exchanges.

Bariatric surgery won't be covered on the exchanges in Alabama, Louisiana, Arkansas, Texas and Mississippi. That's where, according to the Centers for Disease Control, obesity rates are among the highest.

Morton applauds the growing awareness around obesity prevention in the U.S., but, he says, some 15 million Americans who are already severely obese still need medical treatment.

"If they don't have insurance, they're not going to get the therapy," Morton says. "We see cancer therapy covered routinely. We see heart disease covered routinely. Why is it that we don't see obesity coverage routinely?"

Therese Hanna, Executive Director of the Center for Mississippi Health Policy, isn't surprised that obesity treatments are excluded on the insurance exchange in her state. She says it all has to do with keeping cost down for many people who will be buying insurance for the first time.

"With the discussions around what should be covered under the exchange within the state, a lot of it had to do with balancing cost versus the coverage," says Hanna.

Hannah says Mississippians who buy insurance on the exchange will likely be the cashiers, cooks, cleaners and construction workers that make up much of the state's uninsured. And even though many of them will qualify for federal subsidies, the price of monthly premiums must be kept low.

"If you try to include everything, the cost would be so high that people wouldn't be able to afford the coverage, so you defeat the purpose," Hanna says. The discussion in Mississippi, she says has focused on providing care for things like high blood pressure, diabetes and heart disease. "So we have a lot of needs to be covered other than obesity itself."

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Regain After Weight Loss Surgery.

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Left –  Fitbloggin' 2012  Right – This Week – Lost the regain  - Also, 3 pounds to my lowest weight.

Several years ago, a woman messaged on a weight loss surgery forum and told me that my weight chart resembled a roller-coaster and that she wanted to "help me get control."  After a quick Google search — I noted she was seeking a new client for her weight loss surgery coaching business and dumped her "friendship."

Thumbs_Up!

Friends do not pay friends to help them lose weight, maintain weight loss or to help them lose regained weight after weight loss surgery.  If you are paying someone for your friendship, it might be time to redefine that friendship — just saying.  I suppose this changes if your friend happens to be a weight loss professional?  But how often does that happen — and how many weight loss professionals would potentially destroy a friendship with aligning with your weight loss journey?
Um.  No.  A professional would NOT.
  • Weight loss is personal.
  • It is something you choose for yourself when you are ready.
  • Weight loss is not something you can be talked into – nor shamed into.  

Regain after weight loss surgery is also a very touchy subject.  Countless bariatric patients go through it — and less want to talk about it.  But it seems like everyone wants to sell "us" something to fix it.  

Let me repeat –

  • Weight loss is personal.
  • It is something you choose for yourself when you are ready.
  • Weight loss is not something you can be talked into – nor shamed into.  

Yet it seems like the larger community wants "us"  (the regainers) to feel shamed for regaining and wants to sell us another quick-fix.

Let us discuss:  Regain is common.  How much?  Some is very typical.  Sometimes even a lot of regain is normal.  You do not have to be sold into another diet, quick-fix, or scam.  You need to remind yourself why you had weight loss surgery to begin with —

…for your HEALTH.  

Some good links on regain –

 

 

 

 


Joan Rivers on Dr. Oz

So this surprised me.

I guess I didn't know much about the woman.

I was walking on the treadmill last night – and I saw this episode of Dr. Oz.  I have blogged before about Joan Rivers and her outright disgust for obese people (!!)  I wanted to be angry at her.

And then I really listened.

Watch the above link before you rant.

Watch it.  Come back.

Now.  Are you sad for her?  Are you sad?  Because this woman is a Weighty Secret.    She has zero self-esteem.  Zero self-confidence.  Listen to some of the things she says.   

"I loved it, it was fabulous."  -Weighty Secret, Joan Rivers re: Bulimia

She is one of us, just aged and faking hateful things.  

She needs a hug.

It's Joan Rivers uncensored! She talks candidly to Dr. Oz about her husband's suicide, her struggle with bulimia and the insecurities that drove her to plastic surgery. Plus, Joan's daughter Melissa exposes her junk-food habit.

 

 

 

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Good DOES GOOD – #YWM2013 #BBGC Fundraiser

In 139 days the BBGC is descending upon Phoenix, Arizona for the #YWM2013 with the Obesity Action Coalition.  This is the 2nd Annual Event — and we want to be a bigger part of it.  Last year several of us traveled to Dallas, Texas for the 1st Annual YWM Event and LOVED EVERY MINUTE of it.   Note:

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This year — we decided we want to put a ring on it.  

In addition to fundraising for the Walk From Obesity (Walks From Obesities?  Plural… Remember last year – $7,300.) and doing good the Bariatric Bad Girls Club is sponsoring a portion of the #YWM2013 event. I implore YOUR business or group to do the same, it is a worthwhile cause.


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To help the BBGC do good — we are fundraising — as I am just one person but together 
WE ARE MANY —

“One of the marvelous things about community is that it enables us to welcome and help people in a way we couldn't as individuals. When we pool our strength and share the work and responsibility, we can welcome many people, even those in deep distress, and perhaps help them find self-confidence and inner healing.” 

― Jean Vanier

  • Our BBGC ink injected wristbands are black debossed silicone wristbands with HOT pink colored ink injected into the engraved letters.  Pretend they are below, cause my photo is NOT here yet.  

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  • The bracelets are IN PRODUCTION  (I'm watching the tracking…) and will be SHIPPED AS SOON AS THEY ARRIVE.  You will receive a bracelet in a few weeks.
  • Alternatively if you DO NOT WANT A BRACELET and want to SUPPORT THE BBGC CAUSE, you may also simply donate directly to contactmeltingmama@gmail.com at www.paypal.com – below
  •  





Shane Koyczan: “To This Day” … for the bullied and beautiful

Shane Koyczan:

  • "To This Day" … for the bullied and beautiful

This. Man.   Yes this is a complilation of the video I shared before — it has MORE.  

To This Day


When I was a kid
I used to think that pork chops and karate chops
were the same thing
I thought they were both pork chops
and because my grandmother thought it was cute
and because they were my favourite
she let me keep doing it

not really a big deal

one day
before I realized fat kids are not designed to climb trees
I fell out of a tree
and bruised the right side of my body

I didn’t want to tell my grandmother about it
because I was afraid I’d get in trouble
for playing somewhere that I shouldn’t have been

a few days later the gym teacher noticed the bruise
and I got sent to the principal’s office
from there I was sent to another small room
with a really nice lady
who asked me all kinds of questions
about my life at home

I saw no reason to lie
as far as I was concerned
life was pretty good
I told her “whenever I’m sad
my grandmother gives me karate chops”

this led to a full scale investigation
and I was removed from the house for three days
until they finally decided to ask how I got the bruises

news of this silly little story quickly spread through the school
and I earned my first nickname

pork chop

to this day
I hate pork chops

I’m not the only kid
who grew up this way
surrounded by people who used to say
that rhyme about sticks and stones
as if broken bones
hurt more than the names we got called
and we got called them all
so we grew up believing no one
would ever fall in love with us
that we’d be lonely forever
that we’d never meet someone
to make us feel like the sun
was something they built for us
in their tool shed
so broken heart strings bled the blues
as we tried to empty ourselves
so we would feel nothing
don’t tell me that hurts less than a broken bone
that an ingrown life
is something surgeons can cut away
that there’s no way for it to metastasize

it does

she was eight years old
our first day of grade three
when she got called ugly
we both got moved to the back of the class
so we would stop get bombarded by spit balls
but the school halls were a battleground
where we found ourselves outnumbered day after wretched day
we used to stay inside for recess
because outside was worse
outside we’d have to rehearse running away
or learn to stay still like statues giving no clues that we were there
in grade five they taped a sign to her desk
that read beware of dog

to this day
despite a loving husband
she doesn’t think she’s beautiful
because of a birthmark
that takes up a little less than half of her face
kids used to say she looks like a wrong answer
that someone tried to erase
but couldn’t quite get the job done
and they’ll never understand
that she’s raising two kids
whose definition of beauty
begins with the word mom
because they see her heart
before they see her skin
that she’s only ever always been amazing

he
was a broken branch
grafted onto a different family tree
adopted
but not because his parents opted for a different destiny
he was three when he became a mixed drink
of one part left alone
and two parts tragedy
started therapy in 8th grade
had a personality made up of tests and pills
lived like the uphills were mountains
and the downhills were cliffs
four fifths suicidal
a tidal wave of anti depressants
and an adolescence of being called popper
one part because of the pills
and ninety nine parts because of the cruelty
he tried to kill himself in grade ten
when a kid who still had his mom and dad
had the audacity to tell him “get over it” as if depression
is something that can be remedied
by any of the contents found in a first aid kit

to this day
he is a stick of TNT lit from both ends
could describe to you in detail the way the sky bends
in the moments before it’s about to fall
and despite an army of friends
who all call him an inspiration
he remains a conversation piece between people
who can’t understand
sometimes becoming drug free
has less to do with addiction
and more to do with sanity

we weren’t the only kids who grew up this way
to this day
kids are still being called names
the classics were
hey stupid
hey spaz
seems like each school has an arsenal of names
getting updated every year
and if a kid breaks in a school
and no one around chooses to hear
do they make a sound?
are they just the background noise
of a soundtrack stuck on repeat
when people say things like
kids can be cruel?
every school was a big top circus tent
and the pecking order went
from acrobats to lion tamers
from clowns to carnies
all of these were miles ahead of who we were
we were freaks
lobster claw boys and bearded ladies
oddities
juggling depression and loneliness playing solitaire spin the bottle
trying to kiss the wounded parts of ourselves and heal
but at night
while the others slept
we kept walking the tightrope
it was practice
and yeah
some of us fell

but I want to tell them
that all of this shit
is just debris
leftover when we finally decide to smash all the things we thought
we used to be
and if you can’t see anything beautiful about yourself
get a better mirror
look a little closer
stare a little longer
because there’s something inside you
that made you keep trying
despite everyone who told you to quit
you built a cast around your broken heart
and signed it yourself
you signed it
“they were wrong”
because maybe you didn’t belong to a group or a click
maybe they decided to pick you last for basketball or everything
maybe you used to bring bruises and broken teeth
to show and tell but never told
because how can you hold your ground
if everyone around you wants to bury you beneath it
you have to believe that they were wrong

they have to be wrong

why else would we still be here?
we grew up learning to cheer on the underdog
because we see ourselves in them
we stem from a root planted in the belief
that we are not what we were called we are not abandoned cars stalled out and sitting empty on a highway
and if in some way we are
don’t worry
we only got out to walk and get gas
we are graduating members from the class of
fuck off we made it
not the faded echoes of voices crying out
names will never hurt me

of course
they did

but our lives will only ever always
continue to be
a balancing act
that has less to do with pain
and more to do with beauty.

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Live ON and be yourself. #noh8

"No freedom until we're equal, damn right I support it."  

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We press play, don't press pause
Progress, march on
With the veil over our eyes
We turn our back on the cause
Till the day that my uncles can be united by law
When kids are walking 'round the hallway plagued by pain in their heart
A world so hateful some would rather die than be who they are
And a certificate on paper isn't gonna solve it all
But it's a damn good place to start
No law is gonna change us
We have to change us
Whatever God you believe in
We come from the same one
Strip away the fear
Underneath it's all the same love
About time that we raised up

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Bet you forgot about this! Good does good gets good things. #BBGC

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Remember that time YOU donated to the Walk From Obesity in 2012 – and helped Team MMBBGC do THIS –

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I promised to give back the prizes that YOU helped me ( and Team MMBGC!) earn!

Look what we did!

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Out of those who donated to Team MMBGC in 2012, I'll be picking WINNERS and posting them VERY SOON!  (It's a huge list!  THANK YOU!) Lucky!  Lucky!

😀

 

Banning large sodas is legal and smart

CNN) – A state trial judge on Monday blocked New York City's plan for a maximum 16 ounce size for a high-sugar beverage. The ban would have included sodas, energy drinks, fruit drinks and sweetened teas. But it would have excluded alcoholic beverages and drinks that are more than 50% milk, such as lattes. The ban would have applied to restaurants, movie theaters, stadiums and mobile food carts. But it would not have applied to supermarkets and convenience stores, such as 7-Eleven.

Mayor Michael Bloomberg's proposal was met with fierce opposition by the industry and public outrage at the loss of "liberty," the so-called "nanny state" run amok. Beyond all the hype, the industry's vociferous arguments, now adopted by a trial court, are badly flawed.

In fact, the Board of Health has the power, indeed the responsibility, to regulate sugary drinks for the sake of city residents, particularly the poor.